Managing chronic diseases in less developed countriesBMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7370.914 (Published 26 October 2002) Cite this as: BMJ 2002;325:914
All rapid responses
This article is timely and important. Papua New Guinea is in the
midst of the disease transition. There is still a major burden of acute
infectious diseases-Malaria,TB,Measles,Pneumonia and TB and ever
increasing rates of Diabetes mellitus and Cardiovascular disease. The AIDS
figures and deaths rise remorselessly.
In this Capital city the poor live in large insanitary
settlements.There is little "community caring" for people have migrated
from all over the island, far from the village communities and relatives
(wantoks)i.e. the extended family which was the backbone of care in the
past. The settlements have limited sanitation, few houses have inside
water or lavatories, electricity is unusual, violence is rife.
Health professionals are not prepared to go into the settlements to
provide a home nursing or palliative care service.They are attacked,
murdered and women nurses raped.
Dying of AIDS with cryptosporidial diarrhoea and 20 or more bowel actions
a day in such surroundings is hell and a long drawn out hell.
The first requirement then is protection and law and order, winning
communities to police themselves, providing protection for carers and
restoring confidence to them.
The people do care and want to help. The staff are kind, competent
and generous but their safety and well being is vital for a sustainable
response to a long term problem.
Competing interests: No competing interests